【目的】 观察以调理脾胃为中心治疗声敏感的临床疗效，并探讨影响疗效的相关因素。【方法】 以2018年1月至2023年 12月期间广州中医药大学第一附属医院耳鼻咽喉头颈外科门诊收治的符合声敏感诊断标准且资料完整的以调理脾胃为中心 治疗的患者作为研究对象，对转归不明确的患者进行电话、网络等追踪随访，以治疗前后的声敏感严重程度评估指标 （IAHS）得分变化情况作为疗效评估参考指标，以痊愈率和有效率作为疗效分析指标进行统计分析，评价以调理脾胃为中心 的中医治养结合方式治疗声敏感的疗效，同时采用多因素二元Logistic回归分析探讨影响声敏感疗效的相关因素。【结果】 共 收集符合标准的声敏感患者 298 例，其中痊愈 151 例（50.67%），显效 22 例（7.38%），有效 75 例（25.17%），无效 50 例 （16.78%），总有效率为83.22%（248/298）。单因素分析结果显示：治疗后生活方式评分、生活方式调整幅度、声敏感严重程 度、病程、是否伴耳鸣、是否伴听力下降、是否伴眩晕、年龄等 8个因素对疗效有影响，差异均有统计学意义（P < 0.05或 P < 0.01），而性别、职业、受教育程度、噪音接触史与疗效无关（P > 0.05）。多因素二元Logistic回归分析结果显示：治疗后 生活方式评分、生活方式调整幅度、声敏感严重程度、是否伴眩晕、病程5个因素与声敏感痊愈率具有明显相关性（P < 0.05 或 P < 0.01），治疗后生活方式评分、声敏感严重程度、生活方式调整幅度、年龄 4个因素与声敏感有效率具有明显相关性 （P < 0.05或P < 0.01）。【结论】 以调理脾胃为中心的中医治养结合方式对声敏感的疗效较好，其中生活方式、声敏感严重程 度、病程、年龄、是否伴眩晕是影响疗效的相关因素，值得进一步深入研究。

Objective To observe the clinical efficacy of therapy focusing on regulating spleen and stomach for the treatment of acoustic hypersensitivity（AH），which also named as auditory hyperaesthesia，and to explore the relevant factors influencing the efficacy. Methods From January 2018 to December 2023，the patients admitted to the outpatient department of otolaryngology-head and neck surgery of the First Affiliated Hospital of Guangzhou University of Chinese Medicine and diagnosed as AH with complete medical data were included as study subjects. Follow-up through telephone or network was carried out for those patients who with uncertain prognosis. The changes in the pre - and post-treatment scores of Indicators of Acoustic Hypersensitivity Severity（IAHS）were used as the reference index for efficacy evaluation，and the cure rate and effective rate were used as the efficacy analysis indexes for statistical analysis. And then the efficacy of traditional Chinese medicine（TCM）medical care combined with health care focusing on regulating spleen and stomach for the treatment of AH was evaluated. Furthermore，multivariate logistic regression was used to explore the relevant factors influencing the efficacy of AH. Results A total of 298 cases of AH patients meeting the inclusion criteria were collected， among which 151 cases（50.67%）were cured，22 cases（7.38%）were markedly effective，75 cases（25.17%）were effective， and 50 cases（16.78%）were ineffective，with a total effective rate of 83.22%（248/298）. The univariate analysis results showed that eight factors（including post-treatment lifestyle score，range of lifestyle adjustment，severity of AH，duration of the disease，presence of tinnitus，presence of hearing drop，presence of vertigo，and age） had an influence on the efficacy， and the differences were statistically significant （P < 0.05 or P < 0.01）. However，the factors of gender，occupation，education level，and history of noise exposure had no influence on the efficacy（P > 0.05）. The multivariate binary logistic regression analysis showed that five factors，namely posttreatment lifestyle score，range of lifestyle adjustment，severity of AH，presence of vertigo and duration of the disease，had a significant correlation with the cure rate of AH（P < 0.05 or P < 0.01），and four factors，namely post-treatment lifestyle score，severity of AH，range of lifestyle adjustment and age，had a significant correlation with the effective rate of AH（P < 0.05 or P < 0.01）. Conclusion The method of TCM medical care and health care focusing on regulating spleen and stomach exerts a better efficacy for AH patients. And the lifestyle，severity of AH，duration of the disease，age，and presence of vertigo are the relevant factors affecting the outcomes，which is worthy of further in-depth study.

R276.1

国家自然科学基金项目（编号：82274590，81974581）；国家中医药管理局2023年中医药循证能力提升项目；广州市科技计划项目 （编号：202201020308）